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My husband has three polyps in his bladder. Are they dangerous, even if they turn out not to be cancerous? If he has them removed, what will the surgery entail?

— Linda, Kansas

Most polyps in the bladder are actually bladder cancers. The majority of bladder cancers are noninvasive lesions that protrude into the hollow of the bladder on stalks, like a cauliflower. Bladder tumors are identified by cystoscopy, whereby a scope is passed up the urethra into the bladder to allow for visual inspection of the inside of the bladder. This is usually performed in the urologist's office. Treatment involves "transurethral resection" — in simple terms, the doctor scrapes out the tumors with a cautery instrument for pathological examination. The procedure is usually an outpatient surgery, with possible limited hospitalization to obtain tissue for diagnosis and to attempt further treatment. In many cases, resection of the tumors will be the main surgical treatment of a bladder tumor. Additional treatments may involve installation of chemotherapy or immunotherapy agents in the bladder.

A smaller subset of bladder cancers consists of tumors that are invasive. While they may have the appearance of polyps, they invade into the deep muscle of the bladder wall. In these instances, if biopsies confirm the invasive nature of the tumors, surgical removal of the bladder may be necessary. Noninvasive bladder cancers, if they are not removed, can progress to become invasive.

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